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Medicaid and CHIP Quality Resource Library

The Center for Medicaid and CHIP Services (CMCS) partners with states to share best practices and provide technical assistance to improve the quality of care for our beneficiaries. Type in a key search term to see what resources are available, or use the filters below to search and browse our quality improvement resources by Medicaid and CHIP Core Set domain and other fields.

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Findings from 2018-2019 EQR Technical Reports
Data and Statistics, State experiences - Includes EQR tables, graphs, and reports describing performance measures and PIPs for Medicaid managed care plans, by state,Initiation and Engagement of Alcohol and Other Drug Abuse or Dependence Treatment (IET-AD), Medical Assistance With Smoking and Tobacco Use Cessation (MSC-AD), Antidepressant Medication Management (AMM-AD), Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication (ADD-CH), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Screening for Depression and Follow-Up Plan: Ages 12 to 17(CDF-CH), Follow-Up After Hospitalization for Mental Illness: Ages 6–17 (FUH-CH), Follow-Up After Hospitalization for Mental Illness: Age 18 and Older (FUH-AD), Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD-AD), Diabetes Care for People with Serious Mental Illness: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) (HPCMI-AD), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-CH)*, Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP-CH), Concurrent Use of Opioids and Benzodiazepines (COB-AD), Use of Pharmacotherapy for Opioid Use Disorder (OUD-AD)*, Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA-AD), Follow-Up After Emergency Department Visit for Mental Illness (FUM-AD), Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA-AD), Ambulatory Care: Emergency Department (ED) Visits (AMB-CH), Controlling High Blood Pressure (CBP-AD), Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) (HPC-AD), PQI 01: Diabetes Short-Term Complications Admission Rate (PQI01-AD), PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate (PQI05-AD), PQI 08: Heart Failure Admission Rate (PQI08-AD),PQI 08: Heart Failure Admission Rate (PQI08-AD), PQI 15: Asthma in Younger Adults Admission Rate (PQI15-AD), Plan All-Cause Readmissions (PCR-AD), Asthma Medication Ratio: Ages 19–64 (AMR-AD), Asthma Medication Ratio: Ages 19–64 (AMR-AD), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Percentage of Eligibles Who Received Preventive Dental Services (PDENT-CH), Experience of Care Core Set Measures , Long Term Services & Supports Core Set Measure , PC-01: Elective Delivery (PC01-AD), PC-02: Cesarean Birth (PC02-CH), Audiological Diagnosis No Later Than 3 Months of Age (AUD-CH), Live Births Weighing Less Than 2,500 Grams (LBW-CH), Prenatal and Postpartum Care: Timeliness of Prenatal Care (PPC-CH), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Contraceptive Care – Postpartum Women Ages 15–20 (CCP-CH), Contraceptive Care – Postpartum Women Ages 21–44 (CCP-AD), Contraceptive Care – All Women Ages 15–20 (CCW-CH),Asthma Medication Ratio: Ages 5–18 (AMR-CH), Weight Assessment and Counseling for Nutrition and Physical Activity for Children/Adolescents (WCC-CH), Chlamydia Screening in Women Ages 16–20 (CHL-CH), Childhood Immunization Status (CIS-CH), Screening for Depression and Follow-Up Plan: Ages 12–17 (CDF-CH), Well-Child Visits in the First 15 Months of Life (W15-CH), Immunizations for Adolescents (IMA-CH), Developmental Screening in the First Three Years of Life (DEV-CH), Well-Child Visits in the Third, Fourth, Fifth and Sixth Years of Life (W34-CH), Adolescent Well-Care Visits (AWC-CH), Cervical Cancer Screening (CCS-AD), Chlamydia Screening in Women Ages 21–24 (CHL-AD), Flu Vaccinations for Adults Ages 18 to 64 (FVA-AD), Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Breast Cancer Screening (BCS-AD), Adult Body Mass Index Assessment (ABA-AD).
Search Terms
Maternal and Perinatal Health, Birth Outcomes, Contraceptive Care, Delivery Outcomes, Postpartum Care, Prenatal Care, Experience of Care, Primary Care Access and Preventative Care, Adult Screenings, Childhood Screenings, Immunizations, STI Screening, Weight Assessment and Counseling, Well-Child Visits, Dental and Oral Health Services, Behavioral Health, Antipsychotic Drugs, Care of Transitions and Follow-Up, Medication Management, Multiple Complex Conditions, Opioids, Screenings and Follow-Up, Substance Abuse or Dependence Treatment, Tobacco Use Treatment, Care of Acute and Chronic Conditions, Ambulatory Care, Asthma And/or COPD, Cardiovascular Disease, Diabetes, HIV Care, Hospitalizations and Readmissions
Technical Assistance to Support Adult, Child, and Health Home Core Set Reporting for FFY 2019 – May 21, 2019
Template or Toolkit, Webinar - Reviews major changes to the 2019 Child and Adult Core; sets and technical specifications; preview FFY 2019 data quality priorities; discuss technical assistance resources available to states and upcoming technical assistance webinars. Screening for Depression and Follow-Up Plan: Age 18 and Older (CDF-AD), Follow-Up After Hospitalization for Mental Illness: Ages 6–17 (FUH-CH), Follow-Up After Hospitalization for Mental Illness: Age 18 and Older (FUH-AD), Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM-CH)*, Use of Opioids at High Dosage in Persons Without Cancer (OHD-AD), Use of Pharmacotherapy for Opioid Use Disorder (OUD-AD)*,
Follow-Up After Emergency Department Visit for Alcohol and Other Drug Abuse or Dependence (FUA-AD), Follow-Up After Emergency Department Visit for Mental Illness (FUM-AD), Controlling High Blood Pressure (CBP-AD), Comprehensive Diabetes Care: Hemoglobin A1c (HbA1c) Poor Control (>9.0%) (HPC-AD), PQI 01: Diabetes Short-Term Complications Admission Rate (PQI01-AD), PQI 05: Chronic Obstructive Pulmonary Disease (COPD) or Asthma in Older Adults Admission Rate (PQI05-AD),
PQI 08: Heart Failure Admission Rate (PQI08-AD), PQI 15: Asthma in Younger Adults Admission Rate (PQI15-AD), Plan All-Cause Readmissions (PCR-AD),
HIV Viral Load Suppression (HVL-AD), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Live Births Weighing Less Than 2,500 Grams (LBW-CH), Contraceptive Care – Postpartum Women Ages 15–20 (CCP-CH), Contraceptive Care – Postpartum Women Ages 21–44 (CCP-AD), Contraceptive Care – All Women Ages 15–20 (CCW-CH), Contraceptive Care – All Women Ages 21–44 (CCW-AD), Breast Cancer Screening (BCS-AD)
Search Terms
Adult Screenings, Childhood Screenings, Weight Assessment and Counseling, Dental and Oral Health Services, Antipsychotic Drugs, Opioids, Screenings and Follow-Up, HIV Care
The Role of Medicaid and CHIP in Improving Asthma Control
Webinar - Provides an introduction to the Learning Collaborative and an overview of the evidence on what works to improve asthma control with a focus on Medicaid and CHIP populations. Highlights six effective clinical and community-based strategies for improving asthma control and outcomes and presents a sample driver diagram that demonstrates where Medicaid and CHIP programs can influence improvements in the delivery of comprehensive asthma care to improve outcomes.
2019 Adult Core Set Chart Pack, FFY 2018
State experiences - Summarizes state reporting on the quality of health care furnished to adults covered by Medicaid during FFY 2018, which generally covers care delivered in calendar year 2017. PC-01: Elective Delivery (PC01-AD)
Search Terms
Maternal and Perinatal Health, Delivery Outcomes, Behavioral Health, Care of Transitions and Follow-Up
Quality of Care for Children in Medicaid and CHIP: Findings from the 2018 Child Core Set
Data and Statistics, Fact Sheet or TA Briefs, Quality Measure Guidance - Summarizes state reporting on the quality of health care furnished to children covered by Medicaid and CHIP during FFY 2018, which generally covers care delivered in calendar year 2017. The Chart Pack includes detailed analysis of state performance on 23 publicly reported measures, Follow-Up Care for Children Prescribed Attention-Deficit/Hyperactivity Disorder (ADHD) Medication (ADD-CH), Screening for Depression and Follow-Up Plan: Ages 12 to 17(CDF-CH), Follow-Up After Hospitalization for Mental Illness: Ages 6–17 (FUH-CH), Follow-Up After Hospitalization for Mental Illness: Age 18 and Older (FUH-AD), Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP-CH), Concurrent Use of Opioids and Benzodiazepines (COB-AD), Asthma Medication Ratio: Ages 5–18 (AMR-CH), Ambulatory Care: Emergency Department (ED) Visits (AMB-CH), Dental Sealants for 6–9 Year-Old Children at Elevated Caries Risk (SEAL-CH), Percentage of Eligibles Who Received Preventive Dental Services (PDENT-CH), PC-02: Cesarean Birth (PC02-CH), Audiological Diagnosis No Later Than 3 Months of Age (AUD-CH), Live Births Weighing Less Than 2,500 Grams (LBW-CH), Prenatal and Postpartum Care: Timeliness of Prenatal Care (PPC-CH), Prenatal and Postpartum Care: Postpartum Care (PPC-AD), Contraceptive Care – Postpartum Women Ages 15–20 (CCP-CH), Contraceptive Care – All Women Ages 15–20 (CCW-CH), Asthma Medication Ratio: Ages 5–18 (AMR-CH), Chlamydia Screening in Women Ages 16–20 (CHL-CH), Childhood Immunization Status (CIS-CH), Well-Child Visits in the First 15 Months of Life (W15-CH), Immunizations for Adolescents (IMA-CH), Developmental Screening in the First Three Years of Life (DEV-CH), Adolescent Well-Care Visits (AWC-CH), 
Search Terms
Maternal and Perinatal Health, Contraceptive Care, Postpartum Care, Prenatal Care, Primary Care Access and Preventative Care, Adult Screenings, Childhood Screenings, Immunizations, Well-Child Visits, Dental and Oral Health Services, Behavioral Health, Antipsychotic Drugs, Care of Transitions and Follow-Up, Medication Management, Opioids, Screenings and Follow-Up, Substance Abuse or Dependence Treatment, Care of Acute and Chronic Conditions, Ambulatory Care, Asthma And/or COPD, Diabetes, Hospitalizations and Readmissions
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